Where is child and adolescent psychotherapy most needed?

Children and young people who have complex and multiple difficulties, and may stay with services for a long time, have been identified in numerous studies as being the most costly in terms of their use of resources. These are the children and young people who can most benefit from the highly skilled intervention of Child and Adolescent Psychotherapists but may struggle to access them where resources are limited or services focussed on short-term and less intensive interventions. 
In the current age, the type and level of disturbance encountered by specialist child mental health professionals will mostly be severe, enduring and complex, and may involve problems that cut across healthcare, education, social care and youth justice provision. Allied to evidence that improvements are sustained or even enhanced at long-term follow-up this means that it is possible to demonstrate cost savings for services in both the short and medium to long-term by providing specialist interventions for these children, their families and the network of services in contact with them. This approach not only improves outcomes for children but enables a better, more targeted use of resources.
The areas where specialist Child and Adolescent Psychotherapy is most needed include:
  • Complex (co-morbid) presentations particularly linked to early deficits, parental mental health difficulties and incremental developmental trauma
  • Developmental breakdown including psychotic-like symptoms, gender confusion and high risk “acting out” characteristically but not exclusively seen in adolescence
  • Families where there are complex trans-generational issues of mental health, deprivation and neglect
  • Moderate to severe impairments in personality development rooted in early infancy e.g. serious attachment difficulties  
  • Mind-body disturbances including somatisation, psychosomatic problems and the emotional/psychic impact of chronic medical conditions  
  • Depression – moderate and severe with suicidal ideation  
  • Severe, deep-seated anxiety states  
  • Underlying internal states in children and adolescents exhibiting challenging behaviour
  • Eating disorders
  • The emotional development of diagnosed ADHD and ASD children and young people